Download PDF
Vet Comp Orthop Traumatol 2010; 23(02): 84-101
DOI: 10.3415/VCOT-09-01-0006
Clinical Communication
Schattauer GmbH

Headless self-compressing cannulated screw fixation for treatment of radial carpal bone fracture or fissure in dogs

K. Perry
1   Fitzpatrick Referrals, Eashing, Godalming, Surrey, UK
,
N. Fitzpatrick
1   Fitzpatrick Referrals, Eashing, Godalming, Surrey, UK
,
J. Johnson
1   Fitzpatrick Referrals, Eashing, Godalming, Surrey, UK
,
R. Yeadon
› Author Affiliations
Further Information

Publication History

Received: 15 January 2009

Accepted: 14 February 2009

Publication Date:
19 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Objectives: To report the application and clinical outcome of the treatment of radial carpal bone fracture in five dogs using a variably-pitched, headless cannulated compression screw (Acutrak®).

Methods: Arthroscopy was performed prior to surgical repair in three cases. In two cases, a fissure within the radial carpal bone was more clearly apparent when oblique indirect illumination was employed at arthrotomy. Following Acutrak® screw placement via arthrotomy, external coaptation was applied in all cases for a period of two weeks.

Results: Five dogs were treated, of which four were Boxers, and one was a Labrador Retriever crossbreed. All dogs were lame prior to treatment. There was no history of trauma, and all dogs had soft tissue swelling on the dorsal aspect of the radiocarpal joint. In all cases the fissure or fracture line was oblique in orientation, extending disto-medially from the midpoint of the radiocarpal joint proximally to the level of the second carpal bone distally. All fractures treated demonstrated progressive radiographic healing, and all dogs were free of lameness at six weeks postoperatively, but two of the five fractures failed to reach complete radiographic union. All dogs remained lameness-free with mean follow-up of 12.5 months.

Discussion: Acutrak® screws are headless devices which achieve compression, even in small bone fragments. Threads engage both the near and far fracture segments, leading to increased screw-bone contact which maximizes pull-out strength and may increase the fatigue strength of the screw.

Clinical significance: Fixation of two-piece canine radial carpal-bone fractures with the Acutrak® screw proved a reliable alternative to conventional compression screw fixation, and may have benefits over alternatives attributable to screw design and application technique.

Keywords

Acutrak - radial carpal bone - scaphoid - compression screw - carpal arthroscopy
 

  • References

  • 1 Vaughan LC.. Disorders of the carpus I and II. British Vet Jour 1985; 141: 332-341 453–456.
    PubMedGoogle Scholar
  • 2 Li A, Bennett D, Gibbs G. et al. Radial carpal bone fractures in 15 dogs. J Small Anim Pract 2000; 41: 74-79.
    CrossrefPubMedGoogle Scholar
  • 3 Tomlin JL, Pead M, Langley-Hobbs SJ. et al. Radial carpal bone fracture in dogs. J Am Anim Hosp Assoc 2001; 37: 173-178.
    CrossrefPubMedGoogle Scholar
  • 4 Denny HR, Butterworth SJ.. A Guide to Canine and Feline Orthopaedic Surgery. 4th Ed. Oxford, UK: Blackwell Science Ltd; 2000: 413.
    Google Scholar
  • 5 Johnson AL, Houlton JEF, Vannini R.. Chapter 5: Fractures of the maxilla. In: AO Principles of Fracture Management in the Dog and Cat. 2nd ed. Stuttgart, Germany: AO Publishing, Georg Thieme Verlag; 2005: 341.
    Google Scholar
  • 6 Johnson KA.. Carpal injuries. In Bloomberg MS. Dee JF. Taylor RA. eds Canine sports medicine and surgery. Philadelphia: WB Saunders; 1998: 100-119.
    Google Scholar
  • 7 Gnudi G, Mortellaro CM, Bertoni G. et al. Radial carpal bone fracture in 13 dogs. Vet Comp Orthop Traumatol 2003; 16: 178-183.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Gnudi G, Martini FM, Zanichelli S.. Incomplete humeral condylar fracture in two English Pointer dogs. Vet Comp Orthop Traumatol 2005; 18: 243-245.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Marcellin-Little DJ, Deyoung DJ, Ferris KK. et al. Incomplete ossification of the humeral condyle in Spaniels. Vet Surg 1994; 23: 475-487.
    CrossrefPubMedGoogle Scholar
  • 10 Mikic D, Ercegan G, Somer T.. Detailed anatomy of the antebrachiocarpal joint in dogs. Anat Rec 1992; 233: 329-334.
    CrossrefPubMedGoogle Scholar
  • 11 Doman AN, Marcus NW.. Congenital bipartite scaphoid. J Hand Surg Am 1990; 15 A 869-873.
    CrossrefPubMedGoogle Scholar
  • 12 Akahane M, Ono H, Sada M. et al. Bilateral bipartite lunate: A case report. J Hand Surg Am 2002; 27 A 355-359.
    CrossrefPubMedGoogle Scholar
  • 13 Louis DS, Calhoun TP, Garn SM. et al. Congenital bipartite scaphoid – fact or fiction?. J Bone Joint Surg 1976; 58 A 1108-1112.
    CrossrefPubMedGoogle Scholar
  • 14 Mahon A, Craigen M.. Fractures and dislocations of the carpus. Surgery 2006; 24: 433-436.
    PubMedGoogle Scholar
  • 15 Stark HH, Tickard TA, Zemel NP. et al. Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation. J Bone Joint Surg 1988; 70: 982-991.
    CrossrefPubMedGoogle Scholar
  • 16 Green DP.. The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg 1985; 10 A 597-605.
    CrossrefPubMedGoogle Scholar
  • 17 Gelberman RH, Wolock BS, Siegel DB.. Fractures and non-unions of the carpal scaphoid. J Bone Joint Surg Am 1989; 71: 1560-1565.
    CrossrefPubMedGoogle Scholar
  • 18 Fernandez DL.. A technique for anterior wedge-shaped grafts for scaphoid nonunions with carpal instability. J Hand Surg 1984; 9 A 733-737.
    CrossrefPubMedGoogle Scholar
  • 19 Mathoulin C, Haerle M.. Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg 1998; 23: 318-323.
    CrossrefPubMedGoogle Scholar
  • 20 Straw RG, Davis TRC, Dias JJ.. Scaphoid nonunion: Treatment with a pedicled vascularised bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg 2002; 27: 413-416.
    CrossrefPubMedGoogle Scholar
  • 21 Shin AY, Bishop AT.. Pedicled vascularised bone grafts for disorders of the carpus: scaphoid nonunion and Kienbock’s disease. J Am Acad Orthop Surg 2002; 10: 210-216.
    CrossrefPubMedGoogle Scholar
  • 22 Slade JF, Gutow AP, Geissler WB.. Percutaneous internal fixation of scaphoid fractures via an arthroscopically assisted dorsal approach. J Bone Joint Surg Am 2002; 84: 21-36.
    CrossrefPubMedGoogle Scholar
  • 23 Slade JF, Grauer J, Mahoney J.. Arthroscopic reduction and percutaneous fixation of scaphoid fractures with a novel dorsal technique. Orthop Clin North Am 2003; 32: 247-261.
    PubMedGoogle Scholar
  • 24 Sommerkamp T.. Scaphoid AARIF: Arthroscopically assisted reduction and internal fixation of scaphoid fractures. Hand Surg 2003; 1: 192-210.
    PubMedGoogle Scholar
  • 25 Bond CA, Shin AY, McBride MT. et al. Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am 2001; 83 A 483-488.
    CrossrefPubMedGoogle Scholar
  • 26 Bushnell BD, McWilliams AD, Messer TM. et al. Complications in dorsal percutaneous cannulated screw fixation of nondisplaced scaphoid wrist fractures. Hand Surg 2007; 32: 827-833.
    CrossrefPubMedGoogle Scholar
  • 27 Bedi A, Jebson PJ, Hayden RJ. et al. Internal fixation of acute nondisplaced scaphoid waist fractures via a limited dorsal approach: An assessment of radio-graphic and functional outcomes. Hand Surg 2007; 32: 326-329.
    CrossrefPubMedGoogle Scholar
  • 28 Adamany DC, Mikole EA, Frazer BJ.. Percutaneous fixation of the scaphoid through a dorsal approach: An anatomic study. Hand Surg 2008; 33: 327-331.
    PubMedGoogle Scholar
  • 29 Whitelock R.. Conditions of the Carpus in the Dog. In Pract 2001; 23: 2-13.
    CrossrefPubMedGoogle Scholar
  • 30 Piermattei DL, Johnson KA.. An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 4th Ed. Pennsylvania, USA: Saunders; 2004: 254-275.
    Google Scholar
  • 31 Schuind F, Haenkjens P, Van Innis F. et al. Prognostic factors in the treatment of carpal scaphoid nonunions. J Hand Surg Am 1999; 24: 761-776.
    CrossrefPubMedGoogle Scholar
  • 32 Southcott R, Rosman MA.. Non-union of carpal scaphoid fractures in children. J Bone Joint Surg Br 1977; 59 (B) 20-23.
    PubMedGoogle Scholar
  • 33 Fitzpatrick N.. Clinical and radiographic assessment of 83 cases of subtotal coronoid ostectomy (SCO) for treatment of fragmented medial coronoid process (FMCP). VOS Spring meeting, Big Sky; MT, USA.: 2004
    Google Scholar
  • 34 Butterworth SJ, Innes JF.. Incomplete humeral condylar fractures in the dog. J Small Anim Pract 2001; 42: 394-339.
    CrossrefPubMedGoogle Scholar
  • 35 Gundi G, Martini FM, Zannicheli S. et al. Incomplete humeral condylar fracture in two English Pointer dogs. Vet Comp Orthop Traumatol 2005; 18: 243-245.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Kaderly RE, Lamothe M.. Incomplete humeral condylar fracture due to minor trauma in a mature Cocker Spaniel. J Am Anim Hosp Assoc 1992; 28: 361-364.
    PubMedGoogle Scholar
  • 37 Marcellin-Little DJ, DeYoung DJ, Ferris KK. et al. Incomplete ossification of the humeral condyle in Spaniels. Vet Surg 1994; 23: 475-487.
    CrossrefPubMedGoogle Scholar
  • 38 Charles AE, Ness MG, Yeadon R.. Failure mode of transcondylar screws used for treatment of incomplete ossification of the humeral condyle in 5 dogs. Vet Surg 2009; 38: 185-191.
    CrossrefPubMedGoogle Scholar
  • 39 Beadel G, Ferreira L, Johnson JA. et al. Interfragmentary compression across a simulated scaphoid fracture – Analysis of 3 screws. J Hand Surg 2004; 29: 273-278.
    CrossrefPubMedGoogle Scholar
  • 40 Bailey CA, Kuiper JH, Kelly CP.. Biomechanical evaluation of a new composite bioresorbable. J Hand Surg Br 2006; 31: 208-212.
    CrossrefPubMedGoogle Scholar
  • 41 Fitzpatrick N, Farrell M, O'Riordan J. et al. Application of a self-compressing headless variably pitched cannulated screw for treatment of ununited anconeal process in dogs. 13th ESVOT Congress, Munich, Germany 2006. 7th – 10th September. Pp 225.
    PubMedGoogle Scholar
  • 42 Fitzpatrick N, Smith TJ, O'Riordan J. et al. Treatment of incomplete ossification of the humeral condyle with autogenous bone grafting techniques. Vet Surg 2009; 38: 173-184.
    CrossrefPubMedGoogle Scholar
  • 43 Wheeler DL, McLoughlin SW.. Biomechanical assessment of compression screws. Clin Orthop Relat Res 1998; 350: 237-245.
    PubMedGoogle Scholar
  • 44 Bueno ACD, Galuppo LD, Taylor KT. et al. A bio-mechanical comparison of headless tapered variable pitch and AO cortical bone screws for fixation of a simulated slab fracture in equine third carpal bones. Vet Surg 2003; 32: 167-177.
    CrossrefPubMedGoogle Scholar
  • 45 Toby EB, Butler TE, McCormack TJ. et al. Comparison of fixation screws for the scaphoid during application of cyclical bending loads. J Bone Joint Surg 1997; 79 A 1190-1197.
    CrossrefPubMedGoogle Scholar
  • 46 Choi K, Khang G, Goldstein SA.. The elastic moduli and fatigue properties of canine trabecular bone tissue: Special issue in biomechanics. KSME International Journal 2001; 15 (07) 1022-1031.
    CrossrefPubMedGoogle Scholar
  • 47 Miller A, Carmichael S, Anderson TJ. et al. Luxation of the radial carpal bone in four dogs. J Small Anim Pract 1990; 31: 148-154.
    CrossrefPubMedGoogle Scholar
  • 48 Punzet G.. Luxation of the os carpi radiale in the dog – pathogenesis, symptoms, and treatment. J Small Anim Pract 1974; 15: 751-756.
    CrossrefPubMedGoogle Scholar
  • 49 Klein DM, Belsole RJ.. Percutaneous treatment of carpal, metacarpal, and phalangeal injuries. Clin Orthop Relat Res 2000; 375: 116-125.
    CrossrefPubMedGoogle Scholar